Sphingomonas paucimobilis bacteremia and tricuspid valve endocarditis in a patient with intravenous drug use

Sphingomonas paucimobilis is an aerobic, yellow-pigmented, glucose non-fermenting, gram negative bacillus that is a rare cause of human infection found mostly in the immunocompromised and also in intravenous (IV) drug users. We report a case of a 31-year-old female with current IV drug use, who presented with chest pain and was diagnosed with tricuspid valve endocarditis with S. paucimobilis bacteremia and pulmonary infarction of the right middle lobe. The patient initially presented with sharp right sided chest pain. She was treated with meropenem and levofloxacin based on the susceptibility profile. Our purpose is to highlight the treatment options and raise awareness of this uncommon organism. Even though Sphingomonas is considered to be of low-pathogenicity, it can be fatal if not treated properly and not diagnosed early.